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    <title>填写订单2</title>
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</head>
<body>



<!--头部-->
<header></header>


<!--会员页面头部-->
<div class="vip-header"></div>





<div class="vw-order">
    <form action="">
        <div class="wrap">

            <div class="bread-nav clearfix">
                <span>您的当前位置：</span>
                <a href="#">首页</a>
                <span>&gt;</span>
                <a href="#">会员中心</a>
            </div>

            <div class="vip-content clearfix">
                <div class="vip-link">
                    <div class="vip-link-title">会员中心</div>
                    <ul class="vip-link-ul">
                        <li class="vip-link-list">
                            <a href="vip.html">
                                <div class="vip-link-line"></div>
                                <p>商户名称</p>
                            </a>
                        </li>
                        <li class="vip-link-list">
                            <a href="vip-write-order1.html">
                                <div class="vip-link-line"></div>
                                <p>订单填写</p>
                            </a>
                        </li>
                        <li class="vip-link-list">
                            <a href="vip-recent-order.html">
                                <div class="vip-link-line"></div>
                                <p>最近订单</p>
                            </a>
                        </li>
                        <li class="vip-link-list">
                            <a href="vip-history-order.html">
                                <div class="vip-link-line"></div>
                                <p>历史订单</p>
                            </a>
                        </li>
                        <li class="vip-link-list">
                            <a href="vip-download.html">
                                <div class="vip-link-line"></div>
                                <p>报告下载</p>
                            </a>
                        </li>
                        <li class="vip-link-list on">
                            <a href="vip-write-order2.html">
                                <div class="vip-link-line"></div>
                                <p>变更报告</p>
                            </a>
                        </li>
                    </ul>
                </div>


                <div class="vip-right">
                    <div class="vr-order-title clearfix">
                        <div class="vrot-heading">订单填写</div>
                    </div>


                    <div class="vw-content vw-content2">
                        <table class="vw-table vw-table2">
                            <tr>
                                <th width="20"></th>
                                <th width="72"></th>
                                <th width="130"></th>
                                <th width="108"></th>
                                <th width="80"></th>
                                <th width="80"></th>
                                <th width="100"></th>
                                <th width="78"></th>
                                <th width="120"></th>
                            </tr>
                            <tr>
                                <td colspan="7" style="text-align: left;">HDTC．M002</td>
                                <td colspan="2" rowspan="2" style="text-align: left;font-size: 13px;">
                                    地址: 深圳市盐田区深盐路壹海城壹海中心706
                                    <br>
                                    电话: 0755-22729705
                                    <br>
                                    传真: 0755-22729705
                                    <br>
                                    网址: http://www.HDTC.com.cn
                                </td>
                            </tr>
                            <tr>
                                <td colspan="7" height="76"><img src="images/vm-title2.jpg" alt=""></td>
                            </tr>
                            <tr>
                                <td colspan="9">
                                    <div class="vw-box clearfix">
                                        <div class="vw-p fl">报告编号 <span style="font-weight: normal;">（由宏大检测填写）</span> ：</div>
                                        <input class="vw-input1" style="width: 240px;" type="text">
                                    </div>
                                    <div class="vw-box clearfix" style="float: right;margin-left: 0;margin-right: 25px;">
                                        <div class="vw-p fl" style="font-weight: normal;">日期 ：<i class="red-point" style="right: 9px;">*</i></div>
                                        <input class="vw-input1" style="width: 30px;text-align: center;" type="text">
                                        <div class="vw-p fl" style="font-weight: normal;">年</div>
                                        <input class="vw-input1" style="width: 30px;text-align: center;" type="text">
                                        <div class="vw-p fl" style="font-weight: normal;">月</div>
                                        <input class="vw-input1" style="width: 30px;text-align: center;" type="text">
                                        <div class="vw-p fl" style="font-weight: normal;">日</div>
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td rowspan="4">
                                    <span style="font-weight: bold;">送检单位信息</span>
                                </td>
                                <td>
                                    <span class="vw-p">申请单位<i class="red-point">*</i></span>
                                </td>
                                <td colspan="3">
                                    <input class="vw-input1" style="margin-left: 10px;" type="text">
                                </td>
                                <td>
                                <span class="vw-p">
                                    <span class="vw-p">联系人<i class="red-point">*</i></span>
                                </span>
                                </td>
                                <td>
                                    <input class="vw-input1" style="margin-left: 10px;" type="text">
                                </td>
                                <td>
                                <span class="vw-p">
                                    <span class="vw-p">电&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;话<i class="red-point">*</i></span>
                                </span>
                                </td>
                                <td>
                                    <input class="vw-input1" style="margin-left: 10px;" type="text">
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <span class="vw-p">付款单位<i class="red-point">*</i></span>
                                </td>
                                <td colspan="5">
                                    <div class="clearfix">
                                        <div class="radio clearfix">
                                            <label>
                                                <input class="radio-input" type="radio" name="danwei" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">申请单位</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix">
                                            <label>
                                                <input class="radio-input" type="radio" name="danwei" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">其他单位：</span>

                                            </label>
                                            <input class="vw-input1" style="width: 150px;" type="text">
                                        </div>
                                    </div>
                                </td>
                                <td>
                                <span class="vw-p">
                                    <span class="vw-p">传&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;真<i class="red-point">*</i></span>
                                </span>
                                </td>
                                <td>
                                    <input class="vw-input1" style="margin-left: 10px;" type="text">
                                </td>

                            </tr>
                            <tr>
                                <td>
                                    <span class="vw-p">原报告号<i class="red-point">*</i></span>
                                </td>
                                <td colspan="2">
                                    <input class="vw-input1" style="margin-left: 10px;" type="text">
                                </td>
                                <td>
                                    <span class="vw-p">报告状态<i class="red-point">*</i></span>
                                </td>
                                <td colspan="2">
                                    <div class="clearfix">
                                        <div class="radio clearfix">
                                            <label>
                                                <input class="radio-input" type="radio" name="qianfa" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">未签发</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix">
                                            <label>
                                                <input class="radio-input" type="radio" name="qianfa" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">签发</span>
                                            </label>
                                        </div>
                                    </div>
                                </td>
                                <td>
                                <span class="vw-p">
                                    <span class="vw-p">签发日期<i class="red-point">*</i></span>
                                </span>
                                </td>
                                <td>
                                    <div class="clearfix">
                                        <input class="vw-input1" style="width: 30px;text-align: center;" type="text">
                                        <div class="vw-p fl" style="font-weight: normal;">年</div>
                                        <input class="vw-input1" style="width: 16px;text-align: center;" type="text">
                                        <div class="vw-p fl" style="font-weight: normal;">月</div>
                                        <input class="vw-input1" style="width: 16px;text-align: center;" type="text">
                                        <div class="vw-p fl" style="font-weight: normal;">日</div>
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <span class="vw-p">地&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;址<i class="red-point">*</i></span>
                                </td>
                                <td colspan="4">
                                    <input class="vw-input1" style="margin-left: 10px;" type="text">
                                </td>
                                <td colspan="3">
                                    <div class="clearfix">
                                        <span class="vw-p fl">原报告是否退回：</span>
                                        <div class="radio clearfix" style="margin-left: 13px;">
                                            <label>
                                                <input class="radio-input" type="radio" name="tuihui" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">退回</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix" style="margin-left: 13px;">
                                            <label>
                                                <input class="radio-input" type="radio" name="tuihui" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">不退回</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix" style="margin-left: 13px;">
                                            <label>
                                                <input class="radio-input" type="radio" name="tuihui" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">待退回</span>
                                            </label>
                                        </div>
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td rowspan="6">
                                    <span style="font-weight: bold;">变更基础信息</span>
                                </td>
                                <td>
                                    <span class="">委托单位</span>
                                </td>
                                <td colspan="4">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="danwei" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">更改为</span>
                                        </label>
                                        <input class="vw-input1" style="width: 230px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                                <td colspan="3">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="danwei" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">增加</span>
                                        </label>
                                        <input class="vw-input1" style="width: 180px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <span class="">样品名称</span>
                                </td>
                                <td colspan="4">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="yangpin" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">更改为</span>
                                        </label>
                                        <input class="vw-input1" style="width: 230px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                                <td colspan="3">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="yangpin" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">增加</span>
                                        </label>
                                        <input class="vw-input1" style="width: 180px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <span class="">商&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;标</span>
                                </td>
                                <td colspan="4">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="shangbiao" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">更改为</span>
                                        </label>
                                        <input class="vw-input1" style="width: 230px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                                <td colspan="3">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="shangbiao" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">增加</span>
                                        </label>
                                        <input class="vw-input1" style="width: 180px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <span class="">布&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;号</span>
                                </td>
                                <td colspan="4">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="buhao" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">更改为</span>
                                        </label>
                                        <input class="vw-input1" style="width: 230px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                                <td colspan="3">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="buhao" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">增加</span>
                                        </label>
                                        <input class="vw-input1" style="width: 180px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <span class="">声明款号</span>
                                </td>
                                <td colspan="4">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="shengming" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">更改为</span>
                                        </label>
                                        <input class="vw-input1" style="width: 230px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                                <td colspan="3">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="shengming" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">增加</span>
                                        </label>
                                        <input class="vw-input1" style="width: 180px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <span class="">其&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;他</span>
                                </td>
                                <td colspan="4">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="qita" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">更改为</span>
                                        </label>
                                        <textarea class="vw-textarea" style="width: 230px;margin-left: 5px;"></textarea>
                                    </div>
                                </td>
                                <td colspan="3" style="vertical-align: top;">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="qita" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">增加</span>
                                        </label>
                                        <textarea class="vw-textarea" style="width: 180px;margin-left: 5px;"></textarea>
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td rowspan="5">
                                    <span style="font-weight: bold;">变更技术信息</span>
                                </td>
                                <td>
                                    <span class="">产品标准</span>
                                </td>
                                <td colspan="4">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="chanpinbiaozhun" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">更改为</span>
                                        </label>
                                        <input class="vw-input1" style="width: 230px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                                <td colspan="3">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="chanpinbiaozhun" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">增加</span>
                                        </label>
                                        <input class="vw-input1" style="width: 180px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <span class="">产品等级</span>
                                </td>
                                <td colspan="4">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="chanpindengji" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">更改为</span>
                                        </label>
                                        <input class="vw-input1" style="width: 230px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                                <td colspan="3">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="chanpindengji" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">增加</span>
                                        </label>
                                        <input class="vw-input1" style="width: 180px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <span class="">方法标准</span>
                                </td>
                                <td colspan="4">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="fangfabiaozhun" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">更改为</span>
                                        </label>
                                        <input class="vw-input1" style="width: 230px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                                <td colspan="3">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="fangfabiaozhun" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">增加</span>
                                        </label>
                                        <input class="vw-input1" style="width: 180px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <span class="">检测项目</span>
                                </td>
                                <td colspan="4">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="jiance" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">更改为</span>
                                        </label>
                                        <input class="vw-input1" style="width: 230px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                                <td colspan="3">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="jiance" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">增加</span>
                                        </label>
                                        <input class="vw-input1" style="width: 180px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <span class="">其&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;他</span>
                                </td>
                                <td colspan="4">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="qita2" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">更改为</span>
                                        </label>
                                        <input class="vw-input1" style="width: 230px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                                <td colspan="3">
                                    <div class="radio clearfix">
                                        <label>
                                            <input class="radio-input" type="radio" name="qita2" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">增加</span>
                                        </label>
                                        <input class="vw-input1" style="width: 180px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <div class="radio clearfix" style="margin-left: 2px;">
                                        <label>
                                            <input class="radio-input" type="radio" name="fuzhi" value="" />
                                            <i class="option"></i>
                                        </label>
                                    </div>
                                </td>
                                <td>
                                    <span class="vw-p">复制报告</span>
                                </td>
                                <td colspan="7">
                                    <span class="vw-p fl" style="margin-left: 16px;">份数：</span>
                                    <input class="vw-input1" style="width: 230px;margin-left: 5px;" type="text">
                                </td>
                            </tr>
                            <tr>
                                <td rowspan="8">
                                    <span style="font-weight: bold;">中纺标填写</span>
                                </td>
                                <td rowspan="4">
                                    <span>基础信息</span>
                                </td>
                                <td rowspan="2">
                                    <span>存样信息</span>
                                </td>
                                <td colspan="5">
                                    <div class="clearfix">
                                        <div class="radio clearfix">
                                            <label>
                                                <input class="radio-input" type="radio" name="qixian" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">期限内</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix">
                                            <label>
                                                <input class="radio-input" type="radio" name="qixian" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">超过期限（不能变更）</span>
                                            </label>
                                        </div>
                                    </div>
                                </td>
                                <td>
                                    <span>客服部</span>
                                </td>
                            </tr>
                            <tr>
                                <td colspan="5">
                                    <div class="clearfix">
                                        <div class="radio clearfix">
                                            <label>
                                                <input class="radio-input" type="radio" name="tieyang" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">够贴样</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix">
                                            <label>
                                                <input class="radio-input" type="radio" name="tieyang" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">不够贴样（可以贴 <input class="vw-input1" style="width: 22px;float: none;text-align: center;" type="text">
  份）</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix">
                                            <label>
                                                <input class="radio-input" type="radio" name="tieyang" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">没有存样（不能变更）</span>
                                            </label>
                                        </div>
                                    </div>
                                </td>
                                <td rowspan="3" style="padding: 1px;">
                                    <div class="clearfix">
                                        <span style="float: left;margin-top: 3px;">确认：</span>
                                        <div class="radio clearfix" style="margin-left: 0;">
                                            <label>
                                                <input class="radio-input" type="radio" name="biangeng" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">可以变更</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix" style="margin-left: 36px;">
                                            <label>
                                                <input class="radio-input" type="radio" name="biangeng" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">不可以变更</span>
                                            </label>
                                        </div>
                                    </div>
                                    <div class="clearfix" style="margin-top: 10px;">
                                        <span style="float: left;">确认人：</span>
                                        <textarea class="vw-textarea" style="width: 62px;height: 40px;margin-top: -2px;"></textarea>
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td><span>申请单位</span></td>
                                <td colspan="5">
                                    <div class="clearfix">
                                        <div class="radio clearfix">
                                            <label>
                                                <input class="radio-input" type="radio" name="fukuanfang" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">与原报告付款方相同</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix">
                                            <label>
                                                <input class="radio-input" type="radio" name="fukuanfang" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">与原报告付款方不同</span>
                                            </label>
                                        </div>
                                    </div>
                                </td>
                            </tr>
                            <tr style="height: 50px;">
                                <td><span>其&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;他</span></td>
                                <td colspan="5">
                                    <input class="vw-input1" style="width: 400px;margin-left: 10px;" type="text">
                                </td>
                            </tr>
                            <tr>
                                <td rowspan="4">
                                    <span>技术信息</span>
                                </td>
                                <td>
                                    <span>检测一部</span>
                                </td>
                                <td>
                                    <span>重新检测</span>
                                </td>
                                <td colspan="2">
                                    <div class="clearfix">
                                        <div class="radio clearfix" style="margin-left: 0;">
                                            <label>
                                                <input class="radio-input" type="radio" name="jiance1" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">是（项目：<input class="vw-input1" style="width: 22px;float: none;text-align: center;" type="text">）</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix" style="margin-left: 0;">
                                            <label>
                                                <input class="radio-input" type="radio" name="jiance1" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">否</span>
                                            </label>
                                        </div>
                                    </div>
                                </td>
                                <td>
                                    <span>样品</span>
                                </td>
                                <td>
                                    <div class="clearfix">
                                        <div class="radio clearfix" style="margin-left: 10px;">
                                            <label>
                                                <input class="radio-input" type="radio" name="zugou1" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">足够</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix" style="margin-left: 10px;">
                                            <label>
                                                <input class="radio-input" type="radio" name="zugou1" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">不够</span>
                                            </label>
                                        </div>
                                    </div>
                                </td>
                                <td>
                                    <div class="clearfix">
                                        <span style="float: left;margin-top: 1px">确认人：</span>
                                        <input class="vw-input1" style="width: 62px;margin-left: 1px;" type="text">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <span>检测二部</span>
                                </td>
                                <td>
                                    <span>重新检测</span>
                                </td>
                                <td colspan="2">
                                    <div class="clearfix">
                                        <div class="radio clearfix" style="margin-left: 0;">
                                            <label>
                                                <input class="radio-input" type="radio" name="jiance2" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">是（项目：<input class="vw-input1" style="width: 22px;float: none;text-align: center;" type="text">）</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix" style="margin-left: 0;">
                                            <label>
                                                <input class="radio-input" type="radio" name="jiance2" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">否</span>
                                            </label>
                                        </div>
                                    </div>
                                </td>
                                <td>
                                    <span>样品</span>
                                </td>
                                <td>
                                    <div class="clearfix">
                                        <div class="radio clearfix" style="margin-left: 10px;">
                                            <label>
                                                <input class="radio-input" type="radio" name="zugou2" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">足够</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix" style="margin-left: 10px;">
                                            <label>
                                                <input class="radio-input" type="radio" name="zugou2" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">不够</span>
                                            </label>
                                        </div>
                                    </div>
                                </td>
                                <td>
                                    <div class="clearfix">
                                        <span style="float: left;margin-top: 1px">确认人：</span>
                                        <input class="vw-input1" style="width: 62px;margin-left: 1px;" type="text">
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <span>检测三部</span>
                                </td>
                                <td>
                                    <span>重新检测</span>
                                </td>
                                <td colspan="2">
                                    <div class="clearfix">
                                        <div class="radio clearfix" style="margin-left: 0;">
                                            <label>
                                                <input class="radio-input" type="radio" name="jiance3" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">是（项目：<input class="vw-input1" style="width: 22px;float: none;text-align: center;" type="text">）</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix" style="margin-left: 0;">
                                            <label>
                                                <input class="radio-input" type="radio" name="jiance3" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">否</span>
                                            </label>
                                        </div>
                                    </div>
                                </td>
                                <td>
                                    <span>样品</span>
                                </td>
                                <td>
                                    <div class="clearfix">
                                        <div class="radio clearfix" style="margin-left: 10px;">
                                            <label>
                                                <input class="radio-input" type="radio" name="zugou3" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">足够</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix" style="margin-left: 10px;">
                                            <label>
                                                <input class="radio-input" type="radio" name="zugou3" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">不够</span>
                                            </label>
                                        </div>
                                    </div>
                                </td>
                                <td>
                                    <div class="clearfix">
                                        <span style="float: left;margin-top: 1px">确认人：</span>
                                        <input class="vw-input1" style="width: 62px;margin-left: 1px;" type="text">
                                    </div>
                                </td>
                            </tr>
                            <tr style="height: 50px;">
                                <td><span>其&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;他</span></td>
                                <td colspan="5">
                                    <input class="vw-input1" style="width: 400px;margin-left: 10px;" type="text">
                                </td>
                                <td></td>
                            </tr>
                            <tr>
                                <td>
                                    <span style="font-weight: bold;">其他</span>
                                </td>
                                <td colspan="8">
                                    <textarea class="vw-textarea" style="width: 710px;height: 40px;margin-left: 5px;"></textarea>
                                </td>
                            </tr>
                            <tr>
                                <td colspan="2">
                                    <span>分包项目</span>
                                </td>
                                <td colspan="3">
                                    <input class="vw-input1" style="width: 180px;margin-left: 5px;" type="text">
                                </td>
                                <td colspan="2">
                                    <span>分包方</span>
                                </td>
                                <td colspan="3">
                                    <input class="vw-input1" style="width: 180px;margin-left: 5px;" type="text">
                                </td>
                            </tr>
                            <tr>
                                <td colspan="2" rowspan="2">
                                    <span class="vw-p">报告周期<i class="red-point">*</i></span>
                                </td>
                                <td>
                                    <div class="radio clearfix" style="margin-left: 10px;">
                                        <label>
                                            <input class="radio-input" type="radio" name="baogaozhouqi1" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">基础信息</span>
                                        </label>
                                    </div>
                                </td>
                                <td colspan="5">
                                    <div class="clearfix">
                                        <div class="radio clearfix" style="margin-left: 10px;">
                                            <label>
                                                <input class="radio-input" type="radio" name="jichuxinxi" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">常规（2个工作日）</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix" style="margin-left: 10px;">
                                            <label>
                                                <input class="radio-input" type="radio" name="jichuxinxi" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">特快（1个工作日+100%费用）</span>
                                            </label>
                                        </div>
                                    </div>
                                </td>
                                <td rowspan="2">
                                    <span style="color: #ff0000;">注：特快申请须在送检前和客服人员确认时间</span>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <div class="radio clearfix" style="margin-left: 10px;">
                                        <label>
                                            <input class="radio-input" type="radio" name="baogaozhouqi2" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">技术信息</span>
                                        </label>
                                    </div>
                                </td>
                                <td colspan="5">
                                    <div class="clearfix">
                                        <div class="radio clearfix" style="margin-left: 10px;">
                                            <label>
                                                <input class="radio-input" type="radio" name="jishuxinxi" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">常规（3个工作日）</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix" style="margin-left: 10px;">
                                            <label>
                                                <input class="radio-input" type="radio" name="jishuxinxi" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">加急（2个工作日+50%费用）</span>
                                            </label>
                                        </div>
                                        <div class="radio clearfix" style="margin-left: 10px;">
                                            <label>
                                                <input class="radio-input" type="radio" name="jishuxinxi" value="" />
                                                <i class="option"></i>
                                                <span class="opt-text">特快（1个工作日+100%费用）</span>
                                            </label>
                                        </div>
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td colspan="2" rowspan="2">
                                    <span class="vw-p">报告方式<i class="red-point">*</i></span>
                                </td>
                                <td>
                                    <div class="radio clearfix" style="margin-left: 10px;">
                                        <label>
                                            <input class="radio-input" type="radio" name="baogaofangshi" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">自取</span>
                                        </label>
                                    </div>
                                </td>
                                <td colspan="4">
                                    <div class="radio clearfix" style="margin-left: 10px;">
                                        <label>
                                            <input class="radio-input" type="radio" name="baogaofangshi" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">快递（地址）：</span>
                                        </label>
                                        <input class="vw-input1" style="width: 170px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                                <td>
                                    <span class="vw-p">报告文种</span>
                                </td>
                                <td>
                                    <div class="radio clearfix" style="margin-left: 10px;">
                                        <label>
                                            <input class="radio-input" type="radio" name="wenzhong" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">中文</span>
                                        </label>
                                    </div>
                                    <div class="radio clearfix" style="margin-left: 10px;">
                                        <label>
                                            <input class="radio-input" type="radio" name="wenzhong" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">英文</span>
                                        </label>
                                    </div>
                                </td>
                            </tr>
                            <tr>
                                <td>
                                    <div class="radio clearfix" style="margin-left: 10px;">
                                        <label>
                                            <input class="radio-input" type="radio" name="baogaofangshi" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">传真</span>
                                        </label>
                                    </div>
                                </td>
                                <td colspan="4">
                                    <div class="radio clearfix" style="margin-left: 10px;">
                                        <label>
                                            <input class="radio-input" type="radio" name="baogaofangshi" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">E-Mail（地址）：</span>
                                        </label>
                                        <input class="vw-input1" style="width: 170px;margin-left: 5px;" type="text">
                                    </div>
                                </td>
                                <td>
                                    <span class="vw-p">报告份数<i class="red-point">*</i></span>
                                </td>
                                <td>
                                    <input class="vw-input1" style="width: 90px;margin-left: 5px;text-align: center;" type="text">
                                </td>
                            </tr>
                            <tr>
                                <td colspan="2">
                                    <span>不确定度</span>
                                </td>
                                <td colspan="3">
                                    <div class="radio clearfix" style="margin-left: 10px;">
                                        <label>
                                            <input class="radio-input" type="radio" name="buquedingdu" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">要</span>
                                        </label>
                                    </div>
                                    <div class="radio clearfix" style="margin-left: 10px;">
                                        <label>
                                            <input class="radio-input" type="radio" name="buquedingdu" value="" />
                                            <i class="option"></i>
                                            <span class="opt-text">不需要</span>
                                        </label>
                                    </div>
                                </td>
                                <td>
                                    <span>检测费用</span>
                                </td>
                                <td colspan="3">
                                    <span style="float: left;margin-top: 2px;">RMB:</span>
                                    <input class="vw-input1" style="width: 170px;margin-left: 5px;" type="text">
                                </td>
                            </tr>
                            <tr>
                                <td rowspan="2">
                                    <span>备注</span>
                                </td>
                                <td rowspan="2" colspan="4" style="text-align: left;">
                                    1、委托方对所提供的样品信息资料和实物负责，检验方对检验结果负责并予保密；剩余样品委托方须在报告发出1个月内领取，逾期按放弃处理。带"<span style="color: #ff0000;">*</span>"项客户必须填写完全。
                                    <br>
                                    2、送检方申请进行以上检验,并将按规定付费。
                                </td>
                                <td colspan="2">
                                    <span class="vw-p">申请人签名<i class="red-point">*</i></span>
                                </td>
                                <td>
                                    <span class="vw-p">业务员</span>
                                </td>
                                <td>
                                    <span class="vw-p">经办人</span>
                                </td>
                            </tr>
                            <tr>
                                <td colspan="2" height="52">
                                    <input class="vw-input1" style="float: none;text-align: center" type="text">
                                </td>
                                <td>
                                    <input class="vw-input1" style="float: none;text-align: center" type="text">
                                </td>
                                <td>
                                    <input class="vw-input1" style="float: none;text-align: center" type="text">
                                </td>
                            </tr>
                        </table>
                    </div>
                    <div class="vw-wrap">
                        <div class="vw-print">
                            <span>打印</span>
                        </div>
                        <div class="vw-btn clearfix">
                            <!--<input class="vw-btn-online" type="button" value="在线支付">-->
                            <input class="vw-btn-submit" type="submit" value="提交订单">
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </form>
</div>


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<div class="vip-footer"></div>






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        <!--$("input:radio").click(function(){-->
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            <!--var checkedState = $(this).attr('checked');//记录当前选中状态-->
            <!--$("input:radio[name='" + domName + "']").attr('checked',false);//1.-->
            <!--$(this).attr('checked',true);//2.-->
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